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Parathyroid Cancer - Introduction

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Parathyroid Cancer. Use the menu to see other pages. Think of that menu as a roadmap for this complete guide.

About the parathyroid glands

The parathyroid glands are 4 small glands. They are located near the thyroid gland in the neck or chest, which is also called the upper mediastinum. They are part of the endocrine system. Like all parts of the endocrine system, the parathyroid glands play an important role in regulating hormones in the body. These glands make parathyroid hormone (PTH), which regulates the levels of calcium and phosphorus in the blood.

About parathyroid cancer

Cancer begins when healthy cells change and grow out of control, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread. A parathyroid tumor usually develops in 1 of the 4 parathyroid glands.

A parathyroid tumor, whether it is benign or malignant, can cause significant problems because the tumor causes the amount of calcium in the blood to rise, resulting in a serious condition called hypercalcemia. The doctor may need to quickly treat hypercalcemia if a patient is having life-threatening symptoms.

This section covers tumors found in the parathyroid glands. Learn more about tumors that begin in the thyroid gland in a separate guide on Cancer.Net.

The next section in this guide is Statistics. It helps explain the number of people who are diagnosed with this disease and general survival rates. You may use the menu to choose a different section to read in this guide. 

Parathyroid Cancer - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will find information about the number of people who are diagnosed with parathyroid cancer each year. You will read general information on surviving the disease. Remember, survival rates depend on several factors. Use the menu to see other pages.

Parathyroid cancer is quite rare. Almost all tumors that develop in the parathyroid gland are benign, with parathyroid cancer accounting for fewer than 100 cases per year in the United States. If benign parathyroid tumors are not removed completely or properly, they can come back and be very difficult to control. They may result in hypercalcemia that is difficult to control or could cause death.

The 5-year survival rate tells you what percent of people live at least 5 years after the cancer is found. Percent means how many out of 100. The 5-year survival rate for people with parathyroid cancer is about 88%, and the 10-year survival rate is 49%.

It is important to remember that statistics on the survival rates for people with parathyroid cancer are an estimate. The estimate comes from annual data based on the number of people with this cancer in the United States. Also, experts measure the survival statistics every 5 years. So the estimate may not show the results of better diagnosis or treatment available for less than 5 years. People should talk with their doctor if they have questions about this information. Learn more about understanding statistics.

Sources: American Cancer Society and Lawrence Kim, MD, "Parathyroid Carcinoma," eMedicine, Updated December 1, 2015.

The next section in this guide is Risk Factors. It explains what factors may increase the chance of developing this disease. You may use the menu to choose a different section to read in this guide. 

Parathyroid Cancer - Risk Factors

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will find out more about the factors that increase the chance of developing this type of tumor. Use the menu to see other pages.

A risk factor is anything that increases a person’s chance of developing a tumor. Although risk factors often influence the development of a tumor, most do not directly cause the tumor. Some people with several risk factors never develop a tumor, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choice.

There are no known causes for most parathyroid tumors. However, the following risk factor may increase a person’s chance of developing a parathyroid tumor:

  • Family history. A history of parathyroid tumors in a family may raise a person’s risk of developing a parathyroid tumor. A hereditary, or inherited, condition known as multiple endocrine neoplasia may raise an individual’s risk for benign parathyroid tumors. For more information, visit the sections describing multiple endocrine neoplasia type 1 (MEN1) and multiple endocrine neoplasia type 2 (MEN2). All MEN-related parathyroid tumors are benign. No genetic factors have been linked to parathyroid cancer. 

There are no known risk factors for people who do not have a family history of parathyroid tumors.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems this disease can cause. You may use the menu to choose a different section to read in this guide.  

Parathyroid Cancer - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

A person with a parathyroid tumor may experience the following symptoms or signs. Sometimes, a person with a parathyroid tumor does not have any of these changes. The doctor may discover a problem if a blood test shows an increased level of calcium in the blood, a condition called hypercalcemia. Or, the cause of a symptom may be a different medical condition that is not a tumor.

  • Bone pain

  • Kidney problems, including pain in the upper back and excessive urination

  • Stomach pain

  • History of gastroduodenal ulcers, which are ulcers found in the stomach and/or small intestine

  • Weakness

  • Difficulty speaking

  • Vomiting

  • Depression

  • Fatigue

  • Confusion

  • A lump in the neck

  • Insomnia, which is trouble sleeping

  • Malaise, a general feeling of discomfort or illness

If you are concerned about any changes you experience, please talk with your doctor. You doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.

If a parathyroid tumor is diagnosed, relieving symptoms remains an important part of care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. You may use the menu to choose a different section to read in this guide. 

Parathyroid Cancer - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, a tumor. They also do tests to learn if a tumor has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if the tumor has spread. Imaging tests show pictures of the inside of the body. Doctors may also do tests to learn which treatments could work best.

For most types of tumors, a biopsy is the only sure way for the doctor to know whether an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

This list describes options for diagnosing this type of tumor. Not all tests listed below will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of tumor suspected

  • Your signs and symptoms

  • Your age and medical condition

  • The results of earlier medical tests

In addition to a physical examination, the following tests may be used to diagnose a parathyroid tumor:

  • Blood/urine tests. Many types of blood or urine tests may be done if a person has problems with their parathyroid. The most common test is a serum calcium test. Elevated serum calcium levels can suggest the presence of a parathyroid tumor or hyperplasia, which are overactive cells, on 1 or more glands. Another common laboratory test looks for elevated levels of the parathyroid hormone (PTH) and phosphorus levels in the blood. Doctors may suspect parathyroid cancer if these blood tests find a very high level of calcium and/or PTH.

  • Computed tomography (CT or CAT) scan. A CT scan creates a 2-dimensional picture of the inside of the body using x-rays taken from different angles. A computer combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow.

  • Sestamibi/SPECT scan. SPECT is a type of CT scan (see above), and it stands for “single proton emission computerized tomography.” A sestamibi/SPECT scan is a procedure in which a specific protein, called sestamibi, is mixed with a radioactive material and injected into the patient’s vein. A parathyroid tumor will absorb the material, and the tumor will be visible on an x-ray of the neck. A sestamibi/SPECT scan may be recommended if laboratory tests show an elevated level of PTH or it may be used to evaluate parathyroid cancer that has spread to distant parts of the body or come back after treatment. See the Stages section for a full description of these stages.

  • Ultrasound. An ultrasound uses sound waves to create a picture of the internal organs. An ultrasound is very useful for locating a tumor in or around the thyroid gland. However, it has limitations if the tumor is located lower in the neck or upper chest.

  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow.

  • Surgery. Removing the entire tumor during a surgical operation is the most common way to diagnose both benign and cancerous parathyroid tumors. The tumor is then analyzed by a pathologist. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. Parathyroid cancer is usually suspected before an operation based on a high serum calcium level, tumor size, and scans. A biopsy is generally not recommended as a separate procedure from surgery for a parathyroid tumor.

Often, test results showing a higher level of PTH or obvious symptoms of hypercalcemia are signs that cancer may be present. Imaging, such as a CT scan, can also show if cancer has developed. In some instances, a biopsy of the neck can be done, if surgery is not recommended by surgeons experienced in treating parathyroid tumors.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is a cancerous parathyroid tumor, these results can also help the doctor describe the tumor. This is called staging.

The next section in this guide is Stages. It explains the system doctors use to describe the extent of the disease. You may use the menu to choose a different section to read in this guide.   

Parathyroid Cancer - Stages

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. Use the menu to see other pages.

Staging is a way of describing where a cancerous tumor is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to find out the cancer’s stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient’s prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer. For parathyroid cancer, the cancer is typically described as localized, metastatic, or recurrent.

  • Localized. The cancer is only located in the parathyroid gland and has not spread to nearby tissues or organs.
  • Metastatic. The cancer has spread to lymph nodes in the head and neck area or to other parts of the body, such as the lungs, liver, or bone. Lymph nodes are small, bean-shaped organs that help fight infection.
  • Recurrent. Recurrent cancer is cancer that has come back after treatment. The most common place of recurrence is in the neck. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

Source: National Cancer Institute.

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. You may use the menu to choose a different section to read in this guide.   

Parathyroid Cancer - Treatment Options

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will learn about the different treatments doctors use for people with this type of tumor. Use the menu to see other pages.

This section tells you the treatments that are the standard of care for this type of tumor. “Standard of care” means the best treatments known. When making treatment plan decisions, patients are encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Your doctor can help you consider all your treatment options. To learn more about clinical trials, see the About Clinical Trials and Latest Research sections.

Treatment overview

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

The most common treatment options for a parathyroid tumor are surgery, radiation therapy, and treatment of hypercalcemia. Chemotherapy may also be recommended. Treatment will include efforts to both eliminate the tumor and control the amount of calcium in the patient’s bloodstream.

Descriptions of these common treatment options are listed below. Treatment options and recommendations depend on several factors, including the type and stage of the tumor, possible side effects, and the patient’s preferences and overall health. Your care plan may also include treatment for symptoms and side effects, an important part of your care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Treating hypercalcemia

As explained in the Introduction, a parathyroid tumor can cause high levels of calcium in the blood. Having too much calcium in the blood, which is a condition called hypercalcemia, can cause serious problems. It may need immediate treatment.

There are a number of medications used to reduce calcium levels in the blood, including bisphosphonates (Aredia, Bonefos, Loron), calcitonin (multiple brand names), gallium nitrate (Ganite), plicamycin (Mithramycin), or zoledronic acid (Zometa). Most of these drugs are only used for short periods until treatment to remove the tumor can be started.

Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. Surgery is the main treatment for a parathyroid tumor, whether the tumor is benign or cancerous. A surgical oncologist is a doctor who specializes in treating a tumor using surgery. Because parathyroid cancer is so rare and it cannot be cured if it has recurred, surgery with a surgical oncologist who has extensive expertise in thyroid and parathyroid surgery is strongly encouraged whenever parathyroid cancer is suspected.

It is difficult to know before surgery whether a parathyroid tumor is benign or malignant. Parathyroid cancer is the likely diagnosis whenever a patient has profound hypercalcemia, defined as a calcium level greater than 13 mg/dL, or a large parathyroid tumor, defined as larger than 3 centimeters. If this is the case, the parathyroid gland and surrounding structures should be removed. Those surrounding structures should include the same side of the thyroid gland, fatty tissue and lymph nodes surrounding the parathyroid tumor, and the overlying muscle of the center of the neck, called the sternothyroid muscle. The typical surgery for a benign parathyroid tumor is not the same as the surgery for a parathyroid cancer. The doctor may also recommend radiation therapy after surgery to the affected area of the neck (see below).

Surgery for a benign parathyroid tumor is called a parathyroidectomy. Talk with your surgeon about whether minimally invasive surgery for a benign tumor in a single gland is an option for you.

If a surgeon finds the tumor is benign during surgery, it is common to check the patient’s level of PTH in the blood during the operation. If necessary, the surgeon will then put back 1 of the normal parathyroid glands that had been removed earlier in the operation. However, if the tumor is cancerous, the gland should not be put back to avoid any chance of putting cancer cells back into the body.

Before surgery, talk with your surgeon about what to expect, how long recovery will take, and the possible short- and long-term side effects. Learn more about the basics of cancer surgery.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. A radiation therapy regimen, which is your treatment plan, usually consists of a specific number of treatments given over a set period of time. This may also be called a schedule.

Occasionally, radiation therapy may be recommended after surgery for parathyroid cancer. Radiation therapy may help reduce the risk of parathyroid cancer recurring in the neck, but it is difficult to evaluate whether this treatment is beneficial because this type of cancer is so rare.

Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Talk with your doctor about how side effects can be relieved or managed during treatment. Most side effects go away soon after treatment has finished. Learn more about the basics of radiation therapy.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by ending the cancer cells’ ability to grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication.

Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed.

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or combinations of different drugs given at the same time.

Chemotherapy rarely works at treating metastatic or recurrent parathyroid cancer. More clinical trials are needed.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished.

Learn more about the basics of chemotherapy and preparing for treatment. The medications used to treat tumors are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Getting care for symptoms and side effects

Parathyroid cancer and its treatment often cause side effects, such as hypercalcemia, described above. In addition to treatments intended to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care. It works best when palliative care is started as early as needed in the cancer treatment process. People often receive treatment for the cancer at the same time that they receive treatment to ease side effects. In fact, patients who receive both at the same time often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional support, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, or radiation therapy. Talk with your doctor about the goals of each treatment in the treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and palliative care options. During and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it can be addressed as quickly as possible. Learn more about palliative care.

Metastatic parathyroid cancer

If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Also, clinical trials might be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

Your treatment plan may include a combination of surgery, chemotherapy, and radiation therapy. Palliative care will also be important to help relieve symptoms and side effects.

For many patients, a diagnosis of metastatic cancer can be very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it’s important to talk with your doctor about the possibility of the tumor returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if it does return. Learn more about coping with the fear of recurrence.

If the tumor does return after the original treatment, it is called a recurrent tumor. It may come back in the same place, meaning it is a local recurrence, or nearby, which is a regional recurrence. If it comes back in another place, it is a distant recurrence.

The first sign of recurrence after treatment may be high blood calcium levels. Therefore, you may have regular tests to watch for PTH and calcium level changes, as well as ultrasounds of the neck (see Diagnosis).

If there is a recurrence, a new cycle of testing will begin again to learn as much as possible about the tumor. After this testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the treatments described above, such as surgery, chemotherapy, and radiation therapy, but they may be used in a different combination or given at a different pace. Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent tumor. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with recurrent disease often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with recurrence.

If treatment doesn’t work

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for many people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have advanced cancer and who are expected to live less than 6 months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. You may use the menu to choose a different section to read in this guide.  

Parathyroid Cancer - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. Use the menu to see other pages.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for patients with parathyroid cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. In fact, every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested in clinical trials.

Many clinical trials focus on new treatments. Researchers want to learn if a new treatment is safe, effective, and possibly better than the treatment doctors use now. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there are some risks with a clinical trial, including possible side effects and that the new treatment may not work. People are encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects. There are also clinical trials studying ways to prevent cancer.

Deciding to join a clinical trial

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are a way to contribute to the progress in treating parathyroid cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with parathyroid cancer.

Insurance coverage of clinical trials costs differs by location and by study. In some programs, some of the patient’s expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company first to learn if and how your treatment in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” Placebos are usually combined with standard treatment in most cancer clinical trials. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should:

  • Describe all of the patient's options so that the person understands how the new treatment differs from the standard treatment

  • List all of the risks of the new treatment, which may or may not be different than the risks of standard treatment

  • Explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and keep patients safe. You and the research team will carefully review these criteria together.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for a parathyroid tumor, learn more in the Latest Research section.

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

PRE-ACT, Preparatory Education About Clinical Trials

In addition, this website offers free access to a video-based educational program about cancer clinical trials, located outside of this guide.

The next section in this guide is Latest Research. It explains areas of scientific research currently going on for this type of cancer. You may use the menu to choose a different section to read in this guide. 

Parathyroid Cancer - Latest Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will read about the scientific research being done now to learn more about this type of tumor and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about parathyroid cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. Finding a health care team with experience treating this disease is important, as well as one with active collaborations across specialties and participation in clinical trials.

The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the best diagnostic and treatment options for you.

  • Better treatment for hypercalcemia. Researchers are exploring new medications to reduce calcium levels in the blood.

  • Tumor genetics. Researchers are looking at the genes, molecular structure, and other features of parathyroid tumors to learn more about them.

  • Genetics. Researchers are working to learn more about why this type of tumor can run in certain families. See the Risk Factors section for more information.

  • Palliative care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current parathyroid cancer treatments to improve patients’ comfort and quality of life.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding parathyroid tumor, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Treatment. It offers some guidance in how to cope with the physical, emotional, and social changes that cancer and its treatment can bring. You may use the menu to choose a different section to read in this guide.   

Parathyroid Cancer - Coping with Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. This page includes several links outside of this guide to other sections of this website. Use the menu to see other pages.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people don’t experience the same side effects even when they are given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.

As you prepare to start treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. Doctors call this part of cancer treatment “palliative care.” It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for a parathyroid tumor are described in the Treatment Options section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Sometimes, physical side effects can last after treatment ends. Doctors call these long-term side effects. They call side effects that occur months or years after treatment late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Coping with emotional and social effects

You can have emotional and social effects as well as physical effects after a diagnosis. This may include dealing with difficult emotions, such as sadness, anxiety, or anger, or managing your stress level. Sometimes, patients have problems expressing how they feel to their loved ones, or people don’t know what to say in response.

Patients and their families are encouraged to share their feelings with a member of their health care team. You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Coping with financial effects

Cancer treatment can be expensive. It is often a big source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost stops them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations, in a separate part of this website.

Caring for a loved one with cancer

Family members and friends often play an important role in taking care of a person with a parathyroid tumor. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away.

Caregivers may have a range of responsibilities on a daily or as-needed basis. Below are some of the responsibilities caregivers take care of:

  • Providing support and encouragement

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

Learn more about caregiving.

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they are likely to happen?

  • What can we do to prevent or relieve them?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you don’t think the side effects are serious. This discussion should include physical, emotional, and social effects of cancer.

Also, ask how much care you may need at home and with daily tasks during and after treatment. This can help you make a caregiving plan.

The next section in this guide is Follow-up Care. It explains the importance of checkups after cancer treatment is finished. You may use the menu to choose a different section to read in this guide.  

Parathyroid Cancer - Follow-Up Care

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will read about your medical care after cancer treatment is completed, and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with cancer doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the cancer has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence. When parathyroid cancer does recur, it typically reappears between 2 and 5 years after the first surgery, although there is always a risk of recurrence. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. You will have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors including the type and stage of cancer originally diagnosed and the types of treatment given. This should include blood tests to watch for rising PTH and calcium levels (see Diagnosis). Follow-up care should also include imaging scans, such as an ultrasound of the neck, to watch for signs that the cancer has returned.

The anticipation before having a follow-up test or waiting for test results can add stress to you or a family member. This is sometimes called “scan-xiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.

This is also a good time to decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. You may use the menu to choose a different section to read in this guide.   

Parathyroid Cancer - Survivorship

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to see other pages.

What is survivorship?

The word “survivorship” means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and includes people who continue to have treatment over the long term, to either reduce the risk of recurrence or to manage chronic disease.

Survivorship is one of the most complicated parts of having cancer. This is because it is different for everyone.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain about coping with everyday life.

Survivors may feel some stress when their frequent visits to the health care team end after completing treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true when new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexuality and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing

  • Thinking through solutions

  • Asking for and allowing the support of others

  • Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the place where you received treatment.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving in this article.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make positive lifestyle changes.

People recovering from a parathyroid tumor are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

It is important to have recommended medical checkups and tests (see Follow-up Care) to take care of your health. Cancer rehabilitation may be recommended, and this could mean any of a wide range of services such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent and productive as possible.

Talk with your doctor to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: Get this 44-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The booklet is available as a PDF, so it is easy to print out.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes next after finishing treatment.

  • Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including those in different age groups.

The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. You may use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Questions to Ask the Health Care Team

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.

Talking often with your health care team is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for a digital list and other interactive tools to manage your care.

Questions to ask after getting a diagnosis

  • Could my parathyroid tumor be cancerous?

  • Can you explain my pathology report, or laboratory test results, to me?

  • Are more tests needed to find out if the tumor is cancerous?

  • What are my treatment options?

Questions to ask about choosing a treatment and managing side effects

  • What clinical trials are available for me? Where are they located, and how do I find out more about them?

  • Which treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the tumor, help me feel better, or both?

  • Will I be treated for hypercalcemia? If so, why is this important?

  • Who will be part of my health care team, and what does each member do?

  • Who will be leading my overall treatment?

  • What are the possible side effects of this treatment, both in the short term and the long term?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before treatment begins?

  • If I am worried about managing the costs of medical care, who can help me?

  • Whom should I call with questions or problems?

Questions to ask about having surgery

  • How many parathyroid operations does my surgeon perform every year? 

  • How extensive will the surgery be? What can I expect from this type of surgery?

  • Could surgery affect my appearance? Is minimally invasive surgery an option?

  • Is the rapid “parathyroid test” available in the operating room to find out if all of the abnormal tissue has been removed?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • What are the possible long-term effects of having this surgery?

Questions to ask about having radiation therapy or chemotherapy

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • What side effects can I expect during treatment?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

Questions to ask about planning follow-up care

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the treatment I received?

  • What follow-up tests will I need, and how often will I need them?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources. It offers some more resources on this website beyond this guide that may be helpful to you. You may use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Additional Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Parathyroid Cancer. Use the menu to see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Beyond this guide, here are a few links to help you explore other parts of Cancer.Net:

This is the end of Cancer.Net’s Guide to Parathyroid Cancer. You may use the menu to choose a different section to read this guide.